Cancer of the prostate, a common form of cancer, is a disease in which cancer (malignant) cells are found in the prostate.
Cancer of the prostate, a common form of cancer, is a disease in which cancer (malignant) cells are found in the prostate. The prostate is one of the male sex glands and is located just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). The prostate is about the size of a walnut. It surrounds part of the urethra, the tube that carries urine from the bladder to the outside of the body. The prostate makes fluid that becomes part of the semen, the white fluid that contains sperm.
Cancer of the prostate is found mainly in older men. As you get older, your prostate may get bigger and block the urethra or bladder, which can cause you to have difficulty urinating or may interfere with sexual functions. This condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, you may need surgery to correct it. The symptoms of BPH or of other problems in the prostate may be similar to symptoms for prostate cancer. Like most cancers, the chance for cure for cancer of the prostate is greatest when the cancer is diagnosed and treated when it is small (at an early stage). You should see a doctor if you have any of the following: weak or interrupted flow of urine, urinating often (especially at night), difficulty urinating, pain or burning when you urinate, blood in the urine, or nagging pain in the back, "Mps" or pelvis. Often there are no symptoms of early cancer of the prostate. To examine you, usually your doctor will insert a gloved finger into the rectum (a rectal exam) to feel for lumps in the prostate. A special test called an ultrasound, which uses sound waves to make a picture of your bladder, may also be done.
If your doctor feels anything that is not normal, he or she may need to take cells from your prostate and look at them under a microscope. Your doctor will usually do this by putting a needle into the prostate to remove some cells. To get to your prostate, your doctor may put the needle through the rectum or through the space between the scrotum and the anus. (the perineum). This is called a fine needle aspiration or a needle biopsy. Your chance of recovery (prognosis) and choice of treatment depend on the stage of your cancer (whether it is just in the prostate or has spread to other places in the body) and your general state of health.
Stages of Cancer of the Prostate
Once cancer of the prostate has been found (diagnosed), more tests will be done to find out if cancer cells have spread from the prostate to tissues around it or to other parts of the body. This is called "staging." Your doctor needs to know the stage of your disease to plan treatment. The following stages are used for cancer of the prostate:
Prostate cancer at this stage cannot be felt and causes no symptoms. The cancer is only in the prostate and usually is found accidentally when surgery is done for other reasons, such as for BPH.
Stage A1: cancer cells are found in only one area of the prostate
Stage A2: cancer cells are found in many areas of the prostate
The tumor can be felt in the prostate during a rectal exam, but the cancer cells are found only in the prostate gland.
Cancer cells have spread outside the covering (capsule) of the prostate to tissues around the prostate. The glands that produce semen (the seminal vesicles) may have cancer in them.
Cancer cells have spread (metastasized) to lymph nodes or to organs and tissues far away from the prostate.
Stage D1: cancer cells have spread to lymph nodes near the prostate (Lymph nodes are small, bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells.)
Stage D2: cancer cells have spread to lymph nodes far from the prostate or to other parts of the body, such as the bone, liver, or lungs Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the prostate or in another part of the body.
Treatment Options Overview
How Cancer of the Prostate Is Treated
There are treatments for all patients with cancer of the prostate. Three kinds of treatment are commonly used:
surgery (taking out the cancer)
radiation therapy (using high-dose x-rays or other high- energy rays to kill cancer cells)
hormone therapy (using hormones to stop cancer cells from growing).
Surgery is a common treatment for cancer of the prostate. Your doctor may take out the cancer using one of the following operations:
Radical prostatectomy removes the prostate and some of the tissue around it.
Your doctor may do the surgery by cutting into the space between the scrotum and the anus (the perineum) in an operation called a perineal prostatectomy or by cutting into the lower abdomen in an operation called a retropubic prostatectomy. Radical prostatectomy is done only if the cancer has not spread outside the prostate. Often before the prostatectomy is done, your doctor will do surgery to take out lymph nodes in the pelvis to see if they contain cancer. This is called a pelvic lymph node dissection. If the lymph nodes contain cancer, usually your doctor will not do a pro-statectomy, and may or may not recommend other therapy at time. Impotence can occur in men treated with surgery.
Transurethral resection cuts cancer from the prostate using a tool with a small wire loop on the end that is put into the prostate through the urethra. This operation is sometimes done to relieve symptoms caused by the tumor before other treatment or in men who cannot have a radical prostatectomy because of age or other illness.
Cryosurgery is a type of surgery that kills the cancer by freezing it.
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).
Impotence may occur in men treated with radiation therapy. Hormone therapy uses hormones to stop cancer cells from growing. Hormone therapy for prostate cancer can take several forms. Male hormones (especially testosterone) can help prostate cancer grow.
To stop the cancer from growing, female hormones or drugs that decrease the amount of male hormones made may be given. Sometimes an operation to remove the testicles (orchiectomy) is done to stop the testicles from making testosterone. This treatment is usually used in men with advanced prostate cancer. Growth of breast tissue is a common side effect of therapy with female hormones (estrogens); hot flashes can occur after orcffiectomy and other hormone therapies.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the prostate. To date, chemotherapy has not had significant value in treating prostate cancer, but clinical trials are in progress to find more effective drugs.
Treatment by Stage
Treatment of cancer of the prostate depends on the stage of your disease, your age, and your overall condition. If you do not have any symptoms, your doctor may follow you closely without any treatment if you are older, if you have another more serious illness, or if your tumor cells appear only slightly abnormal.
You may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to go into a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired.
For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are going on in most parts of the country for most stages of cancer of the prostate.